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Mrs. M. had another infection. She had blood in her urine. As she talked, she began trembling, then crying, before asking me, “Is my cancer back? Please, please tell me it's not the cancer.” I was stunned at the conversation. Stunned because Mrs. M. was obviously dying.

She had a heart attack 2 weeks before our meeting, which had required stenting. She had been treated for colon cancer, bladder cancer, and pneumonia; her medical history ran on and on. She had become emaciated and too weak to use the bathroom and had to wear diapers continuously. She was developing urinary tract infections—now with resistant species—every few weeks. She was 81.